Quantitative EEG Assessment of Dependence-Related Neurophysiological Patterns Using Rule- and Score-Based Modeling in Substance Use Disorders

Background and Objectives: Substance use disorders (SUDs) are associated with maladaptive neuroplasticity and chronic dysregulation of cortical arousal. EEG provides a non-invasive tool for quantifying these neurophysiological alterations through spectral power and reactivity indices. Prior research consistently reports elevated beta and diminished alpha activity in SUD, reflecting cortical hyperarousal and reduced inhibitory control. This study sought to identify EEG-based markers of dependence-related neurophysiological alterations by integrating rule-based and score-based models incorporating the theta/beta ratio (TBR), alpha and beta powers, the hyperarousal index, and alpha-blocking measures. Materials and Methods: EEG recordings from 47 individuals with SUD were systematically analyzed, focusing on frontal and central cortical regions. Spectral parameters were derived using power spectral density estimation, and composite indices were computed via Python-based signal analysis. A rule-based Dependence Likelihood variable and a continuous Dependence Score (0–1 scale) classified cases as dependence-related (≥0.7), borderline (0.5–0.7), or normal (<0.5). Results: Low alpha power and an elevated hyperarousal index (mean = 3.45) characterized most participants. Dependence-related EEG profiles were identified in 87.2% of cases (mean score = 0.86). Alpha blocking remained intact in 46.8% of cases, whereas post-hyperventilation recovery was attenuated in 61.7% of cases. Segmental analysis indicated sustained cortical activation with low TBR (0.37) and elevated beta across all conditions. Conclusions: Quantitative EEG analysis revealed consistent hyperarousal and inhibitory deficits in SUD. The combined Dependence Likelihood and Score framework provides an interpretable, reproducible approach for identifying dependence-related EEG signatures and holds promise as a biomarker in addiction neurophysiology.